To the Editor.—The Council Report1 on primary care physicians and family caregivers addressed two important aspects of the interaction between primary care physicians and caregivers: the detection of stress among caregivers and suggestions made by physicians to reduce stress. However, we were concerned that the proposed recommendations were more theoretical than practical. We offer several pragmatic applications of the model proposed in the report.The stability of the patient-caregiver unit is, indeed, critical to maintaining frail elderly persons in the community. However, the patient-caregiver unit might be difficult to identify. Some caregivers may be identified when they bring the elderly person to the physician's office,2 but others may be overlooked. Physicians need to ask patients whether they have sole or shared responsibility for aging parents or other relatives, and what that responsibility entails.To evaluate the stability of the patient-caregiver unit, we have developed an instrument (the